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Maximal frequency and SSIL analysis of the snoring sound increased in severe OSAS patients. People should be aware of the importance of snoring sounds. In particular, patients with snoring sounds increasing in intensity and of higher frequency should discuss with their physicians the possibility of OSAS.

Objectives: Anatomic variations of paranasal sinuses are frequent among population that should be analyzed and interpreted accurately. The purpose of this study is to analyze anatomical variants and their relationships of paranasal sinuses in patients with nasal septal deviation undergoing septoplasty. Methods: A total number of 150 patients (74 males, 76 females) with nasal septal deviation undergoing septal surgery were included in this retrospective study. The authors analyzed the direction and the angle of the nasal septal deviation, variations of the nasal turbinates, ethmoidal air cells, paranasal sinus pneumatization, accessory pneumatization of the paranasal complex and sphenoid sinus-related structures and the Keros, optic nerve and Vidian canal classification, and relationships between these structures in the paranasal computed tomography of the patients. Results: The incidence of concha bullosa, Onodi cell, and anterior clinoid pneumatization were higher in patients with nasal septal deviation when compared with current literature. Conclusion: Physicians and surgeons dealing with the nose and maxillofacial region should be able to analyze paranasal computed tomography by themselves and must be aware of these variations during performing septal and craniomaxillofacial surgery.

The purpose of this study is to compare the success rates of fat-graft myringoplasties harvesting adipose grafts from different donor sites (ear lobule vs abdomen). The clinical records of 61 patients (24 males and 37 females) who underwent fat-plug myringoplasty (FPM) were reviewed retrospectively. Fat from ear lobule (FEL) and abdominal fat were used as graft materials. The impact of age, gender, systemic diseases, topography of the perforation, utilization of fat graft materials of different origin on the tympanic membrane closure rate and the effect of FPM on hearing gain was analyzed. Our tympanic membrane (TM) closure rate was 82 %. No statistical significant difference was observed regarding age, gender, comorbidities (septal deviation, hypertension and diabetes mellitus) or habits (smoking). Posterior TM perforations had significantly lower healing rate. The change in TM closure rate considering different adipose tissue donor sites was not statistically significant. The hearing gain of the patients was mostly below 20 dB. Fat-plug myringoplasty (FPM) is a safe, cost-effective and easy operation for selected patients. Abdominal fat graft is as effective as ear lobe fat graft on tympanic membrane healing, has cosmetic advantages and should be taken into consideration when planning fat as the graft source.

Background: The metastasis of papillary thyroid carcinoma to the parapharyngeal space is rare and discussed in the English literature before. Encountering a parapharyngeal mass with cystic appearance on imaging, one should rule out thyroid malignancy as differential diagnosis. Case presentation:The case presented here is a 22-year-old woman who was referred to our clinic with complaints of painless neck mass, dysphagia and hoarseness for two years. After radiologic and pathological examination, the mass thought to be relevant with the thyroid gland. Peroperatively, the tumor was found to originate from the superior pole of the right thyroid gland, with a narrow stalk, and extended following the neurovascular bundle to the lower part of the parapharyngeal space. The bulk was removed via transservical approach with total thyroidectomy. Conclusion:The occurrence of the follicular variant of papillary thyroid carcinoma in the parapharyngeal space is extremely rare. The management of this rare case was discussed with the review of literature.